The objectives of the studies described in this proposal are (1) to replicate and extend the 1979-71 national study of psychotherapeutic drug use in order to assess trends in drug acquisition and use, emotional distress, situational stress, cultural values bearing on medical care, attitudes toward psychotherapeutic drug use, and alternative ways of coping with distress: (1) to evaluate the methods used in the earlier study to classify persons according to levels and types of psychic distress, and to refine these methods for use both in the 1979 national study proposed and for general use in surveys of mental health; and (3) to provide accurate numerical bases for assessing implications of existing and future data on serious adverse reactions associated with particular psychotherapeutic drugs, and to collect data on occurrence of less serious adverse reactions that are not reported to physicians. These objectives will be accomplished through two studies: (1) a methodological and pilot study using samples of (a) medical and psychiatric outpatients (N equals 200) and (b) the general population (N equals 287), who will be evaluated psychiatrically by clinicians and also interviewed at home by survey interviewers. Classification of psychic distress, especially anxiety and depression, based upon responses to a symptom checklist in the survey situation will be compared with clinical evaluations; (2) a national survey of the adult U.S. population aged 18 to 79 (N equals 3000). In this survey, data will be obtained on psychic and somatic distress; life crisis and other stressful life circumstances; use of psychotherapeutic drugs, alcohol, illicit drugs; other ways of coping with distress; attitudes about drug use, the medical system, and mental illness; beliefs about appropriate ways of dealing with psychic distress; and ocurrence of adverse drug reactions. Special attention will be given to these issues as they apply to older persons (69-79).